ASPIRIN (Bayer)What Px Should Know

Dispensing and Medication Counselling

Rem Alfred Felix P. SorilloAdamson Univerity

Uses of Aspirin

• Analgesic, Antipyretic• NSAID• At ↓ dose antithrombotic = Tx of Angina• Ischemic stroke, MI, CABG, PTCA

Dose and Dosing Sched

Adult• Pain, fever– 325–650 mg q4–6h PO or PR (4g/d max)– Arthritis: 3–6 g/d PO in ÷ dose

• Antiplatelet– 81–325 mg PO daily– MI: 81 (preferred)–325 mg PO daily

Dose and Dosing Sched

Pediatric• Antipyretic– 10–15 mg/kg/dose PO or PR q4–6h up to 80

mg/kg/24 h• Kawasaki Dz– 80–100 mg/kg/d ÷ q6h, 3–5 mg/kg/d after fever

resolves

Side effect

• GI upset• Bleeding• Errosion• Thrombocytopenia

Available Dose

• Tabs 325, 500 mg• chew tabs 81 mg• EC tabs 81, 162, 325, 500,

650, 975 mg• SR tabs 650, 800 mg• effervescent tabs 325, 500

mg• supp 125, 200, 300, 600

mg

Cautions

• Pregnancy Category: C• Breastfeeding: Monitor Px, use with caution

• Avoid in viral illness in pedia px (eg. Chickenpox) Reye syndrome

Aspirin + NSAIDs

• Non-selective NSAIDs may antagonise the antiplatelet effects of aspirin and reduce its cardioprotective effects. Some NSAIDs (particularly coxibs) are also associated with an increased thrombotic/cardiovascular risk. Combined use of NSAIDs (including coxibs) and aspirin, even in low-dose, increases the risk of gastrointestinal bleeds.

Aspirin + Food

• Food delays the absorption of aspirin but does not affect the overall amount absorbed.

Aspirin + Sampalok (Tamarindus indica)

• Tamarindus indica fruit extract caused a 3-fold increase in the serum levels of aspirin.

Aspirin + Warfarin and other oral anticoagulant

• High doses of aspirin (4 g daily or more) can increase prothrombin times. It also damages the stomach wall, which increases the risks of bleeding. Low-dose aspirin (75 to 325 mg daily) increases the risk of bleeding when given with warfarin by about 1.5- to 2.5-fold, although, in most studies the absolute risks have been small. Increased warfarin effects have been seen when the salicylates methyl salicylate or trolamine salicylate, were used on the skin.

Aspirin + Alcohol• The combined effect of aspirin and alcohol on the stomach

wall is established. Aspirin 3 g daily for a period of 3 to 5 days induces an average blood loss of about 5 mL. Some increased loss undoubtedly occurs with alcohol, but it seems to be quite small and unlikely to be of much importance in most healthy individuals using moderate doses of aspirin. In one study it was found that alcohol was a mild damaging agent or a mild potentiating agent for other gastrointestinal damaging drugs. It should be remembered that chronic and/or gross overuse of aspirin and alcohol may result in gastric ulceration. Other salicylates would be expected to have similar effects to aspirin.